Answer this question truthfully
### Question: What are the Symptoms of Lyme Disease?
### Response: It's important to know the symptoms of Lyme disease and to seek medical help if you think have Lyme disease. Early signs and symptoms (3 to 30 days after tick bite): The first symptom is usually a red rash at the site of tick bite, which may look like a bullseye, but not all people with Lyme disease have a rash. The rash is called erythema chronicum migrans or erythema migrans (EM). EM occurs in approximately 70 to 80 percent of infected persons. EM begins at the site of a tick bite after a delay of 3 to 30 days (average is about 7 days). EM expands gradually over a period of days reaching up to 12 inches or more (30 cm) across. EM may feel warm to the touch but is rarely itchy or painful. Sometimes, EM clears as it enlarges, resulting in a target or bullseye appearance. EM may appear on any area of the body but is usually present on areas including the axilla, inguinal region, popliteal fossa, or along belt line. The rash may or may not be associated with flu-like symptoms including: Fever and/or chills Headache Body aches Joint aches Stiff neck Fatigue Classic Lyme disease rash - Source: CDC.gov
Late Signs and Symptoms (days to months after tick bite): Severe headaches and neck stiffness Multiple erythema migrans rashes on other areas of the body. Arthritis with severe joint pain and swelling, particularly of the knees and other large joints. Facial palsy (loss of muscle tone or droop on one or both sides of the face). Intermittent pain in tendons, muscles, joints, and bones. Heart palpitations or an irregular heart beat (Lyme carditis). Episodes of dizziness or shortness of breath. Inflammation of the brain and spinal cord. Nerve pain. Shooting pains, numbness, or tingling in the hands or feet. Problems with short-term memory.
Notes Fever and other flu-like symptoms may occur in the absence of rash. A small bump or redness at the site of a tick bite that occurs immediately and resembles a mosquito bite, is common. This irritation generally goes away in 1-2 days and is not a sign of Lyme disease. A rash with a very similar appearance to EM occurs with Southern Tick-associated Rash Illness (STARI), but is not Lyme disease. Ticks can spread other organisms that may cause a different type of rash. What Causes Lyme disease? Lyme disease is caused by a bacterial infection you get from bite of an infected tick. The majority of Lyme disease in North America is caused by bite of black-legged tick, or deer tick (Ixodes scapularis). Other ticks that transmit Lyme disease are the sheep tick, castor bean tick, or European castor bean tick (Ixodes ricinus) in the Europe, the Western black legged tick (Ixodes pacificus) in the Pacific region of North America, and the taiga tick (Ixodes persulactus) in Europe, Central and Northern Asia, China, and Japan. Only 20% of individuals infected with Lyme disease by the deer tick are aware of having had any tick bite. I. scapularis, the primary vector of Lyme disease in Eastern North America - Source: Gross L (2006) A New View on Lyme Disease: Rodents Hold the Key to Annual Risk. PLoS Biol 4(6): e182. https://doi.org/10.1371/journal.pbio.0040182